Higher incidence of adverse events in isolated patients compared with non-isolated patients: A cohort study

Objective To determine whether isolated patients admitted to hospital have a higher incidence of adverse events (AEs), to identify their nature, impact and preventability. Design Prospective cohort study with isolated and non-isolated patients. Setting One public university hospital in the Valencian Community (southeast Spain). Participants We consecutively collected 400 patients, 200 isolated and 200 non-isolated, age =18 years old, to match according to date of entry, admission department, sex, age (±5 years) and disease severity from April 2017 to October 2018. Exclusion criteria: patients age <18 years old and/or reverse isolation patients. Primary and secondary outcome measures The primary outcome as the AE, defined according to the National Study of Adverse Effects linked to Hospitalisation (Estudio Nacional Sobre los Efectos Adversos) criteria. Cumulative incidence rates and AE incidence density rates were calculated. Results The incidence of isolated patients with AEs 16.5% (95% CI 11.4% to 21.6%) compared with 9.5% (95% CI 5.4% to 13.6%) in non-isolated (p<0.03). The incidence density of patients with AEs among isolated patients was 11.8 per 1000?days/patient (95%?CI 7.8 to 15.9) compared with 4.3 per 1000?days/patient (95%?CI 2.4 to 6.3) among non-isolated patients (p<0.001). The incidence of AEs among isolated patients was 18.5% compared with 11% for non-isolated patients (p<0.09). Among the 37 AEs detected in 33 isolated patients, and the 22 AEs detected in 19 non-isolated patients, most corresponded to healthcare-associated infections (HAIs) for both isolated and non-isolated patients (48.6% vs 45.4%). There were significant differences with respect to the preventability of AEs, (67.6% among isolated patients compared with 52.6% among non-isolated patients). Conclusions AEs were significantly higher in isolated patients compared with non-isolated patients, more than half being preventable and with HAIs as the primary cause. It is essential to improve training and the safety culture of healthcare professionals relating to the care provided to this type of patient

Risk analysis for patient safety in surgical departments: Cross-sectional design usefulness

(1) Background: Identifying and measuring adverse events (AE) is a priority for patient safety, which allows us to define and prioritise areas for improvement and evaluate and develop solutions to improve health care quality. The aim of this work was to determine the prevalence of AEs in surgical and medical-surgical departments and to know the health impact of these AEs. (2) Methods: A cross-sectional study determining the prevalence of AEs in surgical and medical-surgical departments was conducted and a comparison was made among both clinical areas. A total of 5228 patients were admitted in 58 hospitals in Argentina, Colombia, Costa Rica, Mexico, and Peru, within the Latin American Study of Adverse Events (IBEAS), led by the Spanish Ministry of Health, the Pan American Health Organization, and the WHO Patient Safety programme. (3) Results: The global prevalence of AEs was 10.7%. However, the prevalence of AEs in surgical departments was 11.9%, while in medical-surgical departments it was 8.9%. The causes of these AEs were associated with surgical procedures (38.6%) and nosocomial infections (35.4%). About 60.6% of the AEs extended hospital stays by 30.7 days on average and 25.8% led to readmission with an average hospitalisation of 15 days. About 22.4% resulted in death, disability, or surgical reintervention. (4) Conclusions: Surgical departments were associated with a higher risk of experiencing AEs

Functional Autonomy Evaluation Levels in Middle-Aged and Older Spanish Women: On Behalf of the Healthy-Age Network

Aging is associated with a progressive loss of functional capacity that affects the health and quality of life of middle-aged and older people. The purpose of this study was to report functional autonomy evaluation levels in middle-aged and older women in the Spanish context. A total of 709 middle-aged and older women, between 50 and 90 years old, were selected to participate in the study. The sample was divided by age category every five years. The functional autonomy levels were determined by the Latin American Group for Maturity (GDLAM) protocol and we developed a classification pattern for middle-aged and older women living in Spain. The GDLAM Index (GI) was then calculated to assess functional autonomy. The classification of the tests and the GI followed the percentile rank (P) Very Good (p 0.85). It was considered that the lower the value found for the percentile, the better the result. The GDLAM protocol showed strong reliability with intraclass correlation coefficient (ICC) values greater than 0.92 in all tests. It is observed that all variables of the GDLAM protocol presented a positive and significant correlation with age (p < 0.001). The Roc Curve showed that GI values higher than 26 (CI95% = 0.97-1.00; p < 0.001) and 32 (CI95% = 0.98-1.00; p < 0.001) for middle-aged and elderly women, respectively, can predict and indicate low functional autonomy. The normative values hereby provided will enable evaluation and adequate interpretation of Spanish middle-aged and older women's functional autonomy

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

BROTE EPIDÉMICO POR TRICHINELLA BRITOVI EN GRANADA DURANTE LA PRIMAVERA DEL 2000

Fundamento: La triquinelosis continúa presentándose en nuestro medio de forma epidémica. La magnitud de cada epidemia depende del alcance del producto contaminado distribuido. En la primavera del año 2000 se investigó en la capital de Granada un episodio ocasionado por la venta de embutidos sin control sanitario. El objetivo de este trabajo es la descripción epidemiológica del brote causado por Trichinella britovi. Métodos: Estudio descriptivo del brote así como de las medidas de control. El alimento vehículo del parásito se investigó mediante encuesta epidemiológica. Resultados: Entre las semanas epidemiológicas 18-22 se declararon 38 casos. Los síntomas identificados con más frecuencia fueron fiebre, mialgias y edemas palpebrales. El 87% de las personas afectadas presentó eosinofilia. El 40% requirieron ingresos hospitalarios. Se encontró T. britovi en la longaniza. Conclusiones: Las epidemias de triquinelosis pueden superar los sistemas de inspección y control actuales, poniendo en riesgo la seguridad alimentaria. La difusión de la alerta sanitaria disminuye la demora diagnóstica. Proponemos la intensificación de la educación sanitaria y continuar con la implantación de programas de autocontrol en industrias y establecimientos, debidamente supervisados y evaluados. Se debe mantener un sistema de vigilancia epidemiológica sensible y de rápida actuación

Brote epidémico por Trichinella britovi en Granada durante la primavera del 2000

Fundamento: La triquinelosis continúa presentándose en nuestro medio de forma epidémica. La magnitud de cada epidemia depende del alcance del producto contaminado distribuido. En la primavera del año 2000 se investigó en la capital de Granada un episodio ocasionado por la venta de embutidos sin control sanitario. El objetivo de este trabajo es la descripción epidemiológica del brote causado por Trichinella britovi. Métodos: Estudio descriptivo del brote así como de las medidas de control. El alimento vehículo del parásito se investigó mediante encuesta epidemiológica. Resultados: Entre las semanas epidemiológicas 18-22 se declararon 38 casos. Los síntomas identificados con más frecuencia fueron fiebre, mialgias y edemas palpebrales. El 87% de las personas afectadas presentó eosinofilia. El 40% requirieron ingresos hospitalarios. Se encontró T. britovi en la longaniza. Conclusiones: Las epidemias de triquinelosis pueden superar los sistemas de inspección y control actuales, poniendo en riesgo la seguridad alimentaria. La difusión de la alerta sanitaria disminuye la demora diagnóstica. Proponemos la intensificación de la educación sanitaria y continuar con la implantación de programas de autocontrol en industrias y establecimientos, debidamente supervisados y evaluados. Se debe mantener un sistema de vigilancia epidemiológica sensible y de rápida actuación

Brote epidémico por "Trichinella britovi" en Granada durante la primavera del 2000

Background: The magnitude of the epidemic depends upon the scope of the contaminated product distributed. In the spring of 2000, an episode caused by the sale of sausage products which had not undergone health inspection. The purpose of this study is to provide an epidemiological description of the outbreak caused by Trichinella britovi. Methods: Descriptive study of the control measures and those affected. The food products contaminated with this parasite was investigated by means of an epidemiological survey. Results: Thirty-eight (38) cases were reported throughout weeks 18-22 of the epidemic. The symptoms most often reported were fever, myalgia and palpebral edema. Eighty-seven percent (87%) of those affected tested positive for eosinophilia. Forty percent (40%) required hospitalization. Late diagnosis was curtailed once the alert had been broadcast. T. Britovi was found in the sausage product. Conclusions: Trichinellosis epidemics can occur despite the current inspection and control systems, placing food safety at risk. Broadcasting a health alert curtails late diagnosis. We propose intensifying health education and continuing the implementation of duly supervised and evaluated self-check programs in industries and establishments. A well-tuned, fast-reacting epidemiological monitoring system must be kept in place.Fundamento: La triquinelosis continúa presentándose en nuestro medio de forma epidémica. La magnitud de cada epidemia depende del alcance del producto contaminado distribuido. En la primavera del año 2000 se investigó en la capital de Granada un episodio ocasionado por la venta de embutidos sin control sanitario. El objetivo de este trabajo es la descripción epidemiológica del brote causado por Trichinella britovi. Métodos: Estudio descriptivo del brote así como de las medidas de control. El alimento vehículo del parásito se investigó mediante encuesta epidemiológica. Resultados: Entre las semanas epidemiológicas 18-22 se declararon 38 casos. Los síntomas identificados con más frecuencia fueron fiebre, mialgias y edemas palpebrales. El 87% de las personas afectadas presentó eosinofilia. El 40% requirieron ingresos hospitalarios. Se encontró T. britovi en la longaniza. Conclusiones: Las epidemias de triquinelosis pueden superar los sistemas de inspección y control actuales, poniendo en riesgo la seguridad alimentaria. La difusión de la alerta sanitaria disminuye la demora diagnóstica. Proponemos la intensificación de la educación sanitaria y continuar con la implantación de programas de autocontrol en industrias y establecimientos, debidamente supervisados y evaluados. Se debe mantener un sistema de vigilancia epidemiológica sensible y de rápida actuación